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State of Tennessee, County of Warren
On this 30th day of June A.D. 1869, personally appeared before me Clerk of the County Court of Warren County, Tennessee, Polly Horton, aged 57 years a resident of the County and State aforesaid, who, first being duly sworn according to law, doth on her oath make the following declarations in order to obtain the benefits of the Provision made by the act of Congress passed on the 2nd February 1833, June 3, 1838 and July 27, 1868 and all other acts for the benefit of persons and widows who served during the Revolutionary War. That she is the widow of Isaac Horton who was, as she verily believes, a Private in the war of the Revolution and that the names of his officers and regiment she is unable to give--and that he was pensioned and paid his pension at the agency of Pulaski, Tennessee, and that he died on or about the 28 day of February 1855 and that his pension certificate, as she verily believes, has been destroyed by some person, she is unable to say by whom.
She further declared that she was married to the said Isaac (in Wayne County, Tennessee, by one John Davis, a Justice of the Peace) Horton on the 12 day of May 1847 and that she was not married to him prior to the 2nd of January 1800 but at the time above stated. She further declares that she is now a widow and that her name previous to her said marriage was Polly Weaver. She further declares that she did not know of any Pension or Bounty due to her for her husbands services until informed of it by a relative of his about the first of June 1869, and this is the reason she has never made application. She further states that she has not in any manner been engaged in, aided or abetted the rebellion in the United States and she hereby appoints W. W. Ferguson of Carthage, Tennessee, her attorney and authorizes him to prosecute this claim and to receive her pension certificate. She further states that she has never had any children by her said husband, Isaac Horton, dec'd.
Her Post Office address is McMinnville, Warren County, Tennessee.
Polly X (her mark) Horton
Attest: George T. Purvil
J. W. Robison
Also personally appeared before me, Squire Hunter and Alexander Wright, residents of Warren County, and the State of Tennessee, whom I certify to be credible persons.